Strangulation in Babies and Children


Strangulation basically refers to the constriction of the windpipe. Strangulation can develop quickly, especially in babies or children. The friends who experiment and the lack of experience make many objects a potential source of danger. Accidents and the subsequent strangulation with clothing or other objects can also occur. The consequences of strangulation depend to a large extent on how tightly and for how long the toddler's neck has been constricted. In the event of strangulation, however, there is an acute danger to life, which is why you should always act quickly. The ambulance service must be alerted depending on the child's condition.

What can a child strangle themselves with?

The list of potentially dangerous items is long. Many pieces of jewelry, chains or everyday objects harbor a danger. For example, cords in jackets can also lead to strangulation. From 2001, many clothing manufacturers stopped using cords in children's clothing because they became aware of the danger. However, especially in inherited or used items of clothing, there may be cords that can wrap around the neck of children. Scarves can also cause strangulation in young children. If one end of the scarf gets stuck on an object, in the worst case scenario the scarf will wrap tightly around the neck and constrict the windpipe. Bicycle helmets can also be dangerous if they are not taken off after cycling. For example when climbing on a climbing spider or similar. the child can hang themselves on the helmet if it gets caught in the ropes.

There are also some potentially dangerous objects in the home: electric cables, curtain cords or key rings. In principle, every object that is long and firm carries a certain risk. The form of strangulation can be divided into two types. Either the object is wrapped too tightly around the neck or the child slips off and hangs itself on the object. The second case is more serious because the entire body weight pulls on the neck.

How do I make the apartment safe?

It is advisable to take a few precautions to reduce the risk of strangulation. In principle, cables or power lines should be placed so that they are inaccessible to children. The cords of blinds or curtains should also be hung so high that the children cannot get hold of them. In the case of babies and toddlers, it is also advisable to take a closer look at the cot. Cords or ribbons should also be removed from the cot. In addition, it is advisable not to lengthen the chain of the pacifier. The guideline for the maximum length of the pacifier chain is 22 centimeters.

If the child at risk has older siblings, it is also necessary to control the older siblings' toys. In some cases, the older siblings' toys (e.g. skipping ropes or similar) can be dangerous for the younger siblings. Check whether jewelry chains can be opened if they are pulled slightly. If the child gets stuck on the chain, it is necessary that the chain opens and the child does not choke. The same goes for key rings that can be hung around your neck. Finally, you should make sure that certain rooms, such as a garden shed with dangerous objects, can only be entered by the child under supervision.

What is umbilical cord strangulation?

Umbilical cord strangulation is the process when the unborn baby wraps the umbilical cord around its neck in the womb. Babies sometimes move a lot in their mother's womb. This can lead to the umbilical cord accidentally wrapping around the baby's neck. Sometimes the umbilical cord even wraps itself around the baby's neck several times. As a rule, however, this is not a problem, as the umbilical cord consists of a special connective tissue. This so-called "gelatinous" connective tissue is particularly flexible and protects against constriction of the umbilical cord vessels. In addition, the baby is not yet breathing through its mouth and nose. In the mother's womb, the baby is supplied with oxygen-rich blood via the umbilical cord. Because of this, having the neck wrapped is not as bad as a born baby. In rare cases, however, the strangulation is so severe that the child dies during pregnancy. In order to rule out any doubts, a so-called color Doppler ultrasound can be carried out by an ultrasound specialist. With this procedure, the umbilical cord can be shown particularly well in the ultrasound. This also shows whether and how often the umbilical cord has been wrapped around the baby's neck.

You may also be interested in this article: Ultrasound examination during pregnancy

What can be the consequences of strangulation?

The consequences of strangulation depend heavily on the duration and severity of the strangulation. The fracture of the neck only occurs when there is a very strong pulling force. This case is atypical for strangulation in children. Babies are more likely to break their necks because the neck muscles are still weak. The greatest danger with strangulation is especially when the neck arteries are pressed. Just a few kilograms of pulling force are enough to keep the neck arteries (Carotid artery) to pull the trigger. The child loses consciousness after about 8-12 seconds. This is because the brain is no longer adequately supplied with blood. After a few minutes, brain damage sets in.

Constricting the airways is also dangerous. This means that the constriction of the windpipe decreases the oxygen content in the lungs. This means that less oxygen is absorbed into the blood through the lungs. After about 60 seconds, the heart rate increases, the concentration of CO2 in the blood increases and there is a feeling of severe shortness of breath. After about 90 seconds you will lose consciousness. The oxygen content in the blood is so low that the brain is severely undersupplied. This can also lead to uncontrolled leakage of urine. After about 150 seconds, cardiac arrhythmias occur and what is known as "terminal gasping" begins.

The lack of oxygen is extremely harmful to the brain. After 2-3 minutes, the lack of oxygen in the brain causes irreversible damage. This means that the damage cannot be reversed. Brain death sets in after about 8-10 minutes. However, this describes the worst case scenario, namely when the windpipe is completely closed. With lighter strangulations, there may only be so-called strand marks. These are choke marks on the neck, which were caused by the rope or cord. Scratches or cuts in the skin can also occur, depending on the material.

How do I behave properly in the event of strangulation?

If strangulation falls, it is important to react quickly.Immediately remove the object that is wrapped around the child's neck. If possible, the ambulance service should be called in parallel if there is a longer or more severe strangulation. If you cannot loosen the object with your hands, try carefully cutting it with scissors. It is also advisable to move the neck as little as possible. In the event of a broken neck, you do as little damage as possible. The baby or child should then be placed on their back on a flat surface. You can now lift your chin slightly to widen your airways. Then you should hold your ear over the child's mouth and nose and listen for breath noises. If the child is not breathing, resuscitation should be started. If it was just a short wrapping of the neck without restricted air supply, one only has to take care of any wounds on the neck.